Nolvadex

In 1969, President Richard M. Nixon declared war on cancer--intending to wipe out the disease in our generation. Despite billions of dollars financing this war, cancer has now become the number one killer of Americans under age 85, and of children. At Nixon's departure in 1974, V.P. Gerald Ford and wife Betty moved into the White House. Seven weeks later Betty Ford began treatment for breast cancer and decided to go public with her disease. With the help of her daughter, Susan, these two high profile women put a face on, and lent a voice to, a previously seldom discussed disease. (1, 2).

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October used to conjure up visions of brilliant yellow and red foliage, orange jack-o-lanterns, and black witches' hats. As awareness about breast cancer reaches astronomical proportions, pink ribbons are everywhere, even on the tongue of my new sneakers, as I happened to discover while preparing this article. Now, as October approaches, consumers are bombarded with pink ribbons, pink banners, pink note pads, pink pens, and more. Hope Nemiroff, Executive Director of Breast Cancer Options refers to this as the "Pinking of America." (3)

Since breast cancer went mainstream, the commercialization of pink has become a non-stop phenomenon. Even the 630 foot St. Louis Gateway Arch glowed pink last October. The National Park Service was initially concerned about setting a precedent by the colored lighting of a national monument, but was quick to express support for a new law ordering the lighting of the arch. Normally bathed in white light, the arch turned pink for one night. (4) What's next? The Statue of Liberty?

Breast Cancer Awareness Month

"October is Breast Cancer Awareness Month" was the brainchild of the Zeneca Corp. (now Astra Zeneca), which pays for and controls all radio and TV ads, pamphlets, and most other information related to this campaign with little or no mention of environmental risk factors from toxic pesticides, chemicals, or other environmental pollutants. Astra Zeneca was once part of the British company, Imperial Chemical Industries. The public is largely unaware that Zeneca is the producer of tamoxifen (Nolvadex), the most widely prescribed breast cancer drug in the world. Zeneca also produced acetochlor, a carcinogenic herbicide, increasingly suspected as a risk factor for developing breast cancer. Zeneca has also been buying up cancer clinics around the country. Zeneca stock has been praised in business articles. Clearly, cancer prevention would not be their top priority. (5)

There is very little funding from government and industry for studies on the relationship of pesticides, and environmental pollutants, to cancer. This line of research is not profit-motivating. However, a recent study co-sponsored by the Breast Cancer Fund and Breast Cancer Action found interesting new links. Their report, "State of the Evidence 2004: What is the Connection Between the Environment and Breast Cancer," details new links between environmental toxins and breast cancer. New evidence strengthens the link between breast cancer and exposure to radiation and toxic chemicals.

Exposure to synthetic chemicals and radiation has contributed more than previously thought to the continuing rise of breast cancer. The report reiterated that exposure to ionizing radiation is the best-established cause of breast cancer. From 1950 to 1991 the incidence of breast cancer in the US increased 90%. The Breast Cancer Fund is the only non-profit national organization that focuses solely on identifying and advocating for elimination of environmental and other preventable causes of breast cancer. Breast Cancer Action is a non-profit national education advocacy organization devoted to ending the breast cancer epidemic. (6).

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The new report offers a "Six-point Plan to Help Reduce the Risk of Breast Cancer and Ultimately End the Epidemic":

* Phase out known carcinogenic and mutagenic chemicals; test all others for effects on health and the environment.

* Hold corporations accountable for hazardous practices and offer incentives for clean green practices.

* Educate the public about health effects of radiation and how to reduce exposure.

* Establish a comprehensive bio-monitoring program to measure the presence of chemicals in people and track health outcomes. (6)

Another part of the October awareness message is to urge women to get yearly mammograms, touting "early detection is the best protection." But, if something has been detected, then you have not been protected. Again, most consumers are unaware that General Electric, heavily invested in the nuclear industry, manufactures all the mammography equipment used in this country. It would be an understatement to say there is little profit in prevention. (5)

The Mammography Dilemma

The American Cancer Society (ACS) and the National Cancer Institute (NCI) began promoting mammograms in the early 1970s as a tool in the war against breast cancer. As early as 1976, John C. Bailar III, then editor of the NCI Journal, questioned the procedure by writing, "The possible benefits of mammography have received more emphasis in the clinical literature than have its defects," adding, "mammography may eventually cause more deaths from breast cancer than it prevents." (7) Sobering words, indeed. It is no surprise that little, if any, research has followed up this concern expressed by other medical experts including John Gofman, MD, PhD, author of Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of This Disease, and founder of the Committee for Nuclear Responsibility (CNR); Janette D. Sherman, MD, author of Life's Delicate Balance, Causes and Prevention of Breast Cancer, and Samuel S. Epstein, MD, author of The Politics of Cancer.

A meta-analysis of randomized trials published in 1997 showed that screening women aged 40 to 49 resulted in an increase in deaths from breast cancer for the first ten years after beginning screening. A significant two-fold increase in breast cancer deaths after three years of screening was found. Women are not likely to be given this information, preventing them from giving an informed consent. (8)

Another study, by Dr. Anthony Miller including approximately 40,000 women in Canada aged 50 to 59 with a 13-year follow-up, showed breast cancer mortality to be equal between one group receiving annual mammograms and another group doing physical examinations only. (9)

The American Cancer Society (ACS) and the National Institutes of Health (NIH), "Want women to feel confident about the benefits associated with regular screening mammography," and are pushing women to start getting mammograms in their forties, and earlier for women with a predisposition, even though denser tissue in younger women is more difficult to properly screen. Hundreds of grassroots organizations genuinely interested in helping women defeat breast cancer perpetuate the message that mammograms save lives, without realizing the potential risk caused by low-dose radiation exposure.

Dr. Sherman wants women to understand that, "Mammograms do not prevent cancer, they can only find an existing cancer." (10) The cumulative radiation damage to DNA from yearly mammograms over a woman's lifetime increases the risk of developing breast cancer in later years. (11)

At a discussion on mammography attended several years ago, I clearly recall a soft spoken young women asking how ethical is it for women with a pre-disposition for breast cancer to begin mammography screening at a young age. She reminded the panelists that any further damage from radiation exposure might actually hasten the onset of developing breast cancer. I don't recall her getting a satisfactory answer at that time, though I will never forget the poignancy of her question.

Current advice to women with BRCA1 and BRCA2 mutations is to combine annual mammograms with bi-annual clinical breast exams beginning at age 25 acknowledging these screening techniques find cancers at an advanced stage. For earlier detection, MRIs and ultrasound are recommended. (12)

Controversy has now erupted in Germany where radiologists at the University of Guttingen say that women with an inherited, increased breast cancer risk should avoid frequent and early mammogram screening. The German researchers suggest that the low-dose X-rays used in mammograms are nearly three times as effective at mutating genes in human cells as conventional X-rays. They advise high-risk women to insist on other screening tests. The standard response to this new study has been to disregard it. (13)

Yet another new report by the National Academy of Sciences reiterates what many scientists have known for a long time--that even low doses of ionizing radiation pose an increased cancer risk. (14)

Mammograms have a 50% to 75% accuracy rate with many false positives leading to anxiety, stress, unnecessary medical costs, and over-treatment. More frustrating is that many tumors are missed. Not all equipment produces high quality results, and interpretation is subjective. (15)

The final decision about what diagnostic procedure to use ultimately rests with the consumer. "Buyer beware" applies to medical consumers as well.

Alternative Screening Techniques

Clinical screening is found to be just as useful as mammography with no radiation exposure, and minus the discomfort. The Canadian National Breast Screening Study (J Natl Cancer Inst, 2000, 92: 1490-1499), and reviews for the mammography screening trials of Gotzsche and Olsen (Lancet 2000 and 2001), have concluded respectively that mammograms are no better than clinical breast exam, with no difference in mortality between women who were screened with mammography, and those who were not. (9, 16)

Ultrasound scans (sonograms) are recommended for women with dense breast tissue because they are more successful in identifying small tumors not detected by mammography, according to researchers in Jerusalem. (17) Ultrasound uses high frequency waves to record an image. Tumors have different sound patterns than cysts or normal tissue. (18)

Multiple Resonance Imagings (MRIs) are recommended for younger women with denser breast tissue. Because there is no radiation exposure they are particularly recommended for high-risk women and for women who may have a recurrence of breast cancer. MRIs are much more costly than mammograms and take longer to complete.

Thermography is a non-invasive, non-ionizing, FDA-approved technology that uses ultra-sensitive infrared cameras to produce diagnostic images of temperature variations in tissue. Thermography can identify suspicious activity at the earliest stages, well in advance of a tumor showing up on a mammogram, and before malignant cells have a chance to spread. Some authorities consider it superior to mammography in identifying tumors in pre-menopausal women and women with dense tissue, fibrocystic disease, or implants. A thermogram screens a larger area and is capable of detecting suspicious activity around the armpit, where mammograms miss tumors in the upper quadrant area. If a hot spot shows up, additional diagnostic techniques may be employed to pinpoint tumor location. Early criticism of too many false positives has been overcome by newer technology. (19-21).

A breath test is among the latest diagnostic tools being studied. It can find cancers earlier than mammograms by checking exhaled breath for alkanes and methylalkanes, which are produced when the body's increased load of environmental toxins accumulates and produces free-radicals, which erode cell membranes. This erosion process generates alkanes and methyalkanes as by-products. In the Sept 2004 issue of Total Wellness, Dr. Sherry Rogers reports that researchers from Columbia Presbyterian Medical Center and four other New York medical centers have found the breath-screening test capable of finding tumors earlier than mammograms. (15)

Follow the Money

Breast cancer has become the champion of charities. You can Run, Walk, March, Bike, Climb, Cook, Clean, Shop, attend an athletic event, or test-drive a car "for the cure."

Besides the American Cancer Society, several other organizations have been established for the purpose of raising money for cancer research. In addition to this, there are scores of retail companies advertising they donate a percentage of their profits "for the cure."

Cancer is a terrible disease. Everyone wants a cure. Americans have been exceedingly generous for over three decades of continuous giving, but getting little in return. Many health advocates fear the public is being taken advantage of, being misled about where the money goes, and why research has been so unproductive in reducing the incidence of cancer.

Follow the Money: An Alliance for Accountability in Breast Cancer evolved from Breast Cancer Action's (BCA) concern about athletic events raising money for breast cancer sponsored by Avon (the largest corporate funder of breast cancer) and the Komen Foundation. Follow the Money campaign specifically calls on fund raising companies

* to be more candid about how much money is raised and how it is spent,

* to establish community advisory boards to guide funding decisions in areas where events are held,

* to increase funding for examining environmental links to breast cancer. (22)

Philanthropy or Hypocrisy

Cosmetic companies are among the most visible supporters in the fight against breast cancer. This has given them an excellent public relations image. In marketing, image is everything. Appearances are only skin deep, however, and after scratching the surface health advocates find myriad toxic chemicals, dyes, fragrances, and preservatives used in thousands of cosmetics and personal care products.

A 2004 study by the Environmental Working Group found that only 18 of 7,500 cosmetics and toiletries had their ingredients fully tested for safety. The remaining 99% had never been fully assessed for long-term safety such as cancer and birth defects. The cosmetic industry is self-regulating, and denies their products contain chemicals that may be linked to breast cancer. Cosmetics are a 35 billion dollar industry in this country. Since the FDA does not regulate the safety of cosmetic ingredients as it does with drugs, perhaps some of the millions raised should be spent researching the cancer links to chemicals in cosmetic products. (23)

Avon, Revlon, Estee Lauder, and Mary Kay are high profile cosmetic companies that advertise their commitment to "finding a cure" by donating a portion of profits to cancer research. Unfortunately, less than five percent goes toward looking at what causes cancer. Cosmetic products contain many toxic ingredients, including parabens and phthalates.

Parabens, used as preservatives are endocrine disrupters that mimic the hormone estrogen and have been found to accumulate in the tissue of women with breast cancer. (3,15,24) Phthalates help lotions penetrate the skin and make nail polish more flexible. Phthalates are also endocrine disruptors, and have been removed from baby toys because of an association with birth defects. With safer alternatives available Breast Cancer Action (BCA) and other advocacy groups believe it is about time for the cosmetic industry to substitute these chemicals with safer alternatives, and to clearly list all ingredients so consumers can make an informed choice.

After years of pressure from activists, Avon, Estee Lauder's Mac and Clinique lines, and Procter and Gamble's Max Factor and Cover Girl lines have finally agreed to remove phthalates from their nail polish products. Breast Cancer Action (BCA) believes corporate conscience belongs in a company's products, not just its marketing. (25)

"Think Before You Pink"

After three decades and billions of dollars spent on looking for a cure, what has been accomplished? Sadly, we have no cure. What we do have includes more diagnostic equipment, more invasive and expensive procedures, and ultimately, more cancer. Instead of "wiping out cancer," cancer seems to be wiping out the health and wealth of increasing numbers of American families.

Among the largest donors to cancer research are companies that profit the most from cancer treatment, or from selling products that contain carcinogenic chemicals. Roche Oncology and the Estee Lauder Companies, Inc. each contribute one million or more to The Breast Cancer Research Foundation (866-FIND-A-CURE), which was founded in 1993 by Evelyn H. Lauder, Senior VP of the Estee Lauder Companies, Inc.

Astra Zeneca, which profits from the manufacture of cancer drugs and pesticides and from owning cancer clinics, donates between $100,000 and $999,999 to The Breast Cancer Research Foundation. Other big donors include Aventis Oncology, Genentech, Clinique (a subsidiary of Estee Lauder), plus several department store chains, media and food corporations. (26)

Breast cancer is a terrifying disease and it is possible that this fear is being exploited by companies that profit from cancer treatment, and by advertising to raise money "for the cure." Environmental advocates are finally demanding to know what companies do with the money raised, and why isn't more research looking at the connection between chemicals and radiation as cancer risks. Advocates are challenging cosmetic companies that enthusiastically promote pink ribbon fund raising to redirect resources into eliminating carcinogenic and mutagenic chemicals from their products. Safer, non-toxic substitutes are available.

Dr. Kenneth Olden, director of the National Institute of Environmental Health Science (NIEHS) believes there is a need for new thinking in science, and encourages researchers to think outside the box. Unfortunately, the funding agencies are still creating the same old boxes into which they insist researchers fit their study designs. I recall one very seasoned health advocate saying scientists won't find what they don't look for. The sad truth is the grant money controls what the scientists can and cannot look for. (27)

As individual consumers we are free to break out of old patterns and to thoroughly question where and how our donations will be used by cancer charities. Donors who are tired of financing the same old research are urged to "Think Before You Pink" this October. The Breast Cancer Action (BCA) advocacy group urges donors to look beyond the pink ribbon philanthropy and join their "Think Before You Pink" campaign in revolutionizing breast cancer research. Interested consumers can obtain free "Think Before You Pink" stickers, watch their new movie, and take action online at www.thinkbeforyoupink.org. (14)

Breast Cancer Action (BCA) accepts no money from any entity that profits from breast cancer or produces products that cause cancer, or profit from health care industries including pharmaceutical companies and chemical manufacturers. Nor do they accept government money. All donations are welcomed. They can be reached at 877-278-6722.

Hope Nemiroff, Executive Director of Breast Cancer Options in New York's Hudson Valley, reminds readers that the pink ribbon symbolizes the daily struggle of women living with breast cancer whose lives are put on hold while they come to terms with the diagnoses, undergo physically challenging treatments, and deal with the worry of recurrence. "Breast cancer is not pink and feminine. It is painful, life-threatening, and real. "BC Options provides information on Risk Reduction and safe products to use, and offers for sale a Risk Reduction Calendar for $10.00. To order call 845-657-8221, email nemiroff@hvaccess.com or visit www.breastcanceroptions.org. (3)

Consumer Advocacy Web Sites

www.thinkbeforeyoupink.org

www.bcaction.org, info@bcaction.org, 877-2786722

www.breastcanceroptions.org

www.ewg.org/reports/skindeep

www.babylonbreastcancer.org

References

1. Rogers, S, MD, Total Wellness (800-846-6687), June 2005.

2. Rader, D, "You Give Back, You Don't Give Up, "PARADE Mgz., July 10, 2005.

3. Nemiroff, H, "The Pinking of America," Celebrate Life!, Jan/Feb 2005, Oncology Program, Benedictine Hosp, Kingston, NY.

4. "Arch to Glow Pink for Anti-Cancer Cause," NY Times, Oct., 24, 2004.

5. Williams, RM, "Breast Cancer Awareness Month," TLDP #195, Oct 1999. p. 13RMW

6. "State of the Evidence 2004 Report," Nemiroff@hvaccess.com, Nov. 9, 2004.

7. Sherman, J, MD, Life's Delicate Balance, Causes & Prevention of Breast Cancer, Taylor & Francis, NY 2000. (Call 703-329-8223 to order bk.)

8. Wolfe, S, MD, "Breast Cancer: New Info. About Screening Mammography and Genetics," Health Letter, V01.20, N0.1, Jan 2004 (Public Citizen Health Research Group).

9. Spanier, B, "Do Annual Mammograms Save Lives," CRAAB, V01.6, N0.3 Summer 2004.

10. Sherman, J, MD, "More on Mammograms," Washington Post, p. A 20, March 7, 2002.

11. Gofman, J, MD, PhD, Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of This Disease, CNR Bk. Div. 1996, Committee for Nuclear Responsibility, Inc., PO Box 421993, S.F., CA, 94142.

12. www.medicalnewstoday.com/?newsid=13423, 14/Sept2004, from Nemiroff@hvaccess, July 29, 2005.

13. Edwards, R, "Risk of mammograms for certain women," (New Scientist News Service), Times Herald-Record, Middletown, NY, Nov 12, 2002.

14. BCA E-newsletter (takeaction@bcaction.org), July 2005.

15. Rogers, S, MD, Total Wellness (800-846-6687), Sept 2004.

16. Rogers, S, MD, Total Wellness (800-846-6687), Dec 2001.

17. "Phthalates Are Poison!" Babylon Breast Cancer News, Vol. 9, N0.4, (www.babylonbreastcancer.org), Babylon, NY.

18. ACS (800-227-2345) phone call, July 29, 2005.

19. Williams, RM, "Thermography," TLfDP #198. Jan 2000.

20. "Thermal Imaging Processing," TLfDP #217/218, Aug/Sept 2001.

21. Nichols, S, "Beyond the Mammogram," Chronogram (www.chronogram.com), June 2005, Kingston, NY.

22. Brenner, B, "Avon and Beyond," BCA News (www.bcaction.org). Dec 2005/Jan 2005.

23. Goldstein, D, "Dangerous Cosmetics," The Herald, March 29, 2005, Miami, FL.

24. Williams, RM, "Cosmetic Chemicals," TLfDP #247/248, Feb/Mar 2004.

25. Salgado, B, "Beauty and the Beast: Activists Work for Safer Cosmetics," BCA News (www.bcaction.org), July/Aug 2005.

26. The Breast Cancer Research Foundation ad (866-FIND-A-CURE), NY Times, October 31, 2004.

27. "Safe Cosmetics Campaign," BCA News, (www.bcaction.org), Dec 2004/Jan 2005.

by Rose Marie Williams, MA

156 Sparkling Ridge Road * New Paltz, New York 12561 USA

845-255-0836 * Fax 845-255-5101 * jwill52739@aol.com

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